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The aim of the present systematic review was to investigate the effect of residual bone height (RBH) and vertical bone gain on new bone formation (NBF) and graft shrinkage after lateral sinus lifts using different biomaterials. Methods: An electronic search was conducted on three databases to identify randomized controlled trials (RCTs) published until January 2021 with at least one follow-up at 6 months and at least five patients treated, comparing biomaterials used for maxillary sinus augmentation with a lateral approach. Graft volumetric changes, RBH, vertical bone gain, implant failure, and post-operative complications were evaluated. The risk of bias was assessed using the Cochrane tool. Results: We used 4010 identified studies, of which 21 were RCTs. Overall, 412 patients and 533 sinuses were evaluated. Only three publications had an overall low risk of bias. After 6 months, xenograft (XG) showed the least volume reduction (7.30 ± 15.49%), while autogenous graft (AU) was the most reabsorbed (41.71 ± 12.63%). NBF appeared to not be directly correlated with RBH; on the contrary, the overall linear regression analysis showed that NBF significantly decreased by 1.6% for each mm of postoperative vertical graft gain. This finding suggests that the greater the augmentation, the lower the NBF. A similar tendency, with a regression coefficient even higher than the overall one, was also observed with alloplast (AP) and XG. Conclusions: The present results suggested that NBF was essentially independent of preoperative bone height. On the contrary, the smaller the volume was of the graft placed, the higher the amount of new bone formed, and the smaller the graft shrinkage was. Minimizing the augmentation volume might be beneficial to graft healing and stability especially when using AP and XG. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose: The aim of this prospective study was to assess clinical outcomes and peri-implant bone level changes around tilted and axial implants supporting full-arch fixed immediate rehabilitations up to 60 months of loading. Material and Methods: Forty-seven patients (22 women and 25 men) were included in the study. Each patient received a full-arch fixed bridge supported by two axial and two distal tilted implants. Loading was applied within 48 hours of surgery. Patients were scheduled for follow-up at 6, 12, 18, 24 months, and annually up to 5 years. At each follow-up, plaque level and bleeding scores were assessed and radiographic evaluation of marginal bone level change was performed. Periapical radiographs were taken using a paralleling technique, and subsequently scanned at 600 dpi. An image analysis software was used to assess bone level. Results: A total of 33 mandibles and 16 maxillae were rehabilitated (two patients received a fixed prosthesis in both arches). One hundred ninety-six Nobel Biocare implants of 4 mm diameter were placed. The mean follow-up duration was 52.8 months (range 30-66 months) in the mandible, and 33.8 months (range 22-40 months) in the maxilla. All subjects attended the scheduled follow-up visits. No implant was lost. No significant difference in marginal bone loss was found between axial and tilted implants in both jaws, at each follow-up. No significant difference in bone loss was found between mandible and maxilla, for both axial and tilted implants at each comparable time frame, although slightly higher mean values were always found for the mandible. Conclusion: The use of tilted implants in the immediate rehabilitation of fully edentulous jaws is safe and is not associated to a higher marginal bone loss as compared to axially placed implants. [ABSTRACT FROM AUTHOR]

To investigate the prevalence, location, size and course of the anastomosis between the dental branch of the posterior superior alveolar artery (PSAA), known as alveolar antral artery (AAA), and the infraorbital artery (IOA). The first part of the study was performed on 30 maxillary sinuses deriving from 15 human cadaver heads. In order to visualize such anastomosis, the vascular network afferent to the sinus was injected with liquid latex mixed with green India ink through the external carotid artery. The second part of the study consisted of 100 CT scans from patients scheduled for sinus lift surgery. An anastomosis between the AAA and the IOA was found by dissection in the context of the sinus anterolateral wall in 100% of cases, while a well-defined bony canal was detected radiographically in 94 out of 200 sinuses (47% of cases). The mean vertical distance from the lowest point of this bony canal to the alveolar crest was 11.25±2.99 mm (SD) in maxillae examined by CT. The canal diameter was <1 mm in 55.3% of cases, 1-2 mm in 40.4% of cases and 2-3 mm in 4.3% of cases. In 100% of cases, the AAA was found to be partially intra-osseous, that is between the Schneiderian membrane and the lateral bony wall of the sinus, in the area selected for sinus antrostomy. A sound knowledge of the maxillary sinus vascular anatomy and its careful analysis by CT scan is essential to prevent complications during surgical interventions involving this region. Rosano G, Taschieri S, Gaudy J-F, Weinstein T, Del Fabbro M. Maxillary sinus vascular anatomy and its relation to sinus lift surgery. Clin. Oral Impl. Res. , 2011; 711-715 doi: 10.1111/j.1600-0501.2010.02045.x [ABSTRACT FROM AUTHOR]

Objectives: To evaluate prevalence, size, location and content of foramina and bony canals located on the lingual side of the mandibular midline. Material and methods: The prevalence and the size of midline lingual foramina and canals visible above and/or below genial spines and their distances from the mandibular base were measured in 60 dry mandibles from adult human cadavers. In addition, macro-anatomic dissections were performed on another 20 mandibles injected with red latex to investigate the vascular canal contents associated with these midline lingual foramina and canals. Results: A total of 118 foramina were detected. All mandibles investigated had at least one lingual foramen at the midline above the genial spines, located at a mean height of 12.5±2.1 mm (SD) from the inferior border of the mandible. Macro-anatomic dissections showed a clear vascular branch entering the mandibular midline as a single vessel from a sublingual-sublingual anastomosis in 19 out of 20 mandibles studied (95%). Conclusion: Blood vessels in the floor of the mouth may be in close proximity to the lingual cortical plate of the mandibular midline in most cases. This implies that bleeding can occur when the mandibular cortical plate is perforated even minimally. As a consequence, the authors suggest a careful planning of implant positioning at mandibular midline, possibly opting for the use of an even number of implants in the interforaminal region, avoiding the risk of surgical trauma to the lingual cortical plate of the mandibular midline. [ABSTRACT FROM AUTHOR]

Background: Augmentation of the edentulous atrophic anterior region is a challenging situation. The purpose of this article was to evaluate the effectiveness of a collagenated cortical bone lamina of porcine origin for horizontal ridge augmentation in patients with inadequate alveolar ridge width undergoing immediate post-extraction implantation in the anterior sites, and to report on implant survival rates/complications. Materials and methods: The cases were extracted electronically from a large database according to these specific inclusion criteria: patients with inadequate alveolar ridge width in the anterior maxilla or mandible, who underwent immediate post-extraction implant placement and simultaneous alveolar bone reconstruction using xenogeneic cortical bone lamina. An additional layer of palatal connective tissue graft was inserted between lamina and the vestibular mucosa, for improving soft tissue healing. A collagenated bone substitute was additionally placed in the gap between the lamina and implant surface in all patients. The main outcomes were implant survival and complications. Results: Forty-nine patients with 65 implants were included. Patients' mean age at the time of implant surgery was 60.0 ± 13.6 years. The mean follow-up was 60.5 ± 26.6 months after implant placement. The implant survival was 100%. Four postoperative complications occurred in four patients. No specific factor was found to be associated with complication occurrence. Conclusion: The use of collagenated cortical bone lamina can be considered as a successful option for alveolar reconstruction in immediate post-extraction implant insertion procedures in anterior regions with inadequate alveolar ridge width. [ABSTRACT FROM AUTHOR]

The aim of this work is to develop an accurate finite element model able to reproduce a standard experimental set-up for the evaluation of mechanical failure of a dental implant system. The considered system is composed of a fixture, an abutment and a connecting screw. We analysed the behaviour of the implant system considering three different designs of the fixture, in order to establish which one provides the better mechanical behaviour. After the definition of the numerical models, loading conditions were selected in order to reproduce the same stress state found in previous mechanical failure tests. Preloading and functional loading conditions were simulated. The analysis of the numerical results shows that the structure yielding is due to the fixture neck plastic deformation, that increases the load eccentricity and then the bending stress on the connecting screw. Only slight differences were found between the three implant systems in the amount and distribution of stress. The model reproduces properly the implant systems and the experimental set-up. The goodness of the model can be summarised as: realistic geometrical structure, elastoplastic model for the material description, correct definition of the contacts and the existing tolerance among the different system components, reproduction of the preloading stress condition. The present study permitted to define a valid procedure for the realization of numerical models of implant systems. [ABSTRACT FROM AUTHOR]

Examines the pulmonary arteriolar vasomotion during th development of mild hydraulic edema. Changes in subpleural pulmonary arteriolar diameter; Evaluation of the perivascular interstitial volume; Requirements for the minimization of alveolocapillary membrane thickness.

Evaluates changes in subpleural pulmonary arteriolar diameter and perivascular interstitial volume during development of mild hydraulic edema. Record on images of subpleural pulmonary microvessels; Dilation of arterioles; Diameter of perivascular interstitial.

Examines the pressure of steady-state pleural fluid flow and the effect of lung buoyancy. Creation of pressure distribution; Infiltration of lung with perfluorocarbon liquid; Modification of force balance in the pleural fluid.

Evaluates pulmonary interstitial pressure and tissue matrix structure in acute hypoxia. Measurement of the pulmonary interstitial pressure; Fragmentation of chondroitin sulfate and heparan sulfate-proteoglycans; Significance of gel filtration.

Studies pulmonary interstitial pressure and tissue matrix structure in acute hypoxia. Doubling of pulmonary arterial pressure after hypoxic exposure; Time course of pulmonary arterial pressure and left atrial pressure in control normoxia and hypoxia; Resistance of tissue matrix to an increase in extravascular water.

Presents a study which described the alterations induced by acute hypoxic exposure on pulmonary and microvascular interstitial fluid dynamics and extracellular matrix structure in experimental animals. Effect of hypoxic exposure on lung tissue; Methodology; Results.

Background: Platelet concentrates are biological, autologous products obtained from the patient's whole blood, consisting of a supraphysiological concentration of platelets and growth factors, that have proved beneficial in different applications in the medical and dental fields. They are used in several medical and dental applications to enhance tissue healing. Previous evidence shows that platelet concentrates may be beneficial in patients with compromised systemic conditions, in which the healing process is impaired. Aim: To evaluate the 5-year clinical outcome of implant treatment using acid-etched implants with calcium ions-modified surface in association with plasma rich in growth factors, in patients with systemic diseases of a different nature. Methods: Charts of 99 medically compromised patients, who had received a total of 224 dental implants from January 2013 to June 2013, were retrospectively evaluated. Patients were divided into four groups, according to their condition: diabetes (n = 39 patients), osteoporosis (n = 36), lupus erythematosus systemic (n = 5), rheumatoid arthritis (n = 19). The main outcomes were implant survival, marginal bone level (MBL) change and complications throughout follow-up. Results: Mean follow-up was 63.06 ± 1.90 months (range 60.1 to 66.4 months). In total, eight implants failed in 6 diabetic patients and 4 in 3 patients with rheumatoid arthritis. Overall 5-year implant survival was 94.6%. In total, 30 complications occurred in 24 patients, mostly transient, and no severe adverse event occurred. Overall MBL change was 0.45 ± 0.12 mm, with no significant differences among groups. Conclusions: In the present sample of medically compromised patients, rehabilitation with calcium ions-modified surface implants associated with plasma rich in growth factors proved to be a safe and effective treatment. The satisfactory results achieved after 5-year follow-up are comparable to those historically reported for healthy patients. [ABSTRACT FROM AUTHOR]

Analysis of short-term results regarding dimensional stability of post-extraction sockets managed via a preservation protocol using deproteinized bovine bone matrix and a xenogeneic collagen matrix. Materials and methods Fifteen patients needing extraction of one single-rooted premolar tooth were treated in a pilot study. Five patients were treated in each centre. After tooth extraction, sockets were filled with anorganic bovine bone matrix and covered with a xenogeneic collagen matrix. Six months later, implants were placed. Dimensional changes in the treated sites were digitally evaluated using the best-fit superimposition of pre-and post-socket preservation models. Results After six months of healing, the vertical reduction of the grafted sites was 0.31 ± 0.24 mm (p < 0.001). Volumetric analysis of superimposed models showed an average palatal-lingual contraction of 0.33 ± 0.51 mm3 (p = 0.02). At the vestibular level, the average contraction was found to be 0.8 ± 0.3 mm3 (p < 0.001). Finally, the analysis of linear variations in the treated sites on a single sagittal section at the crystal level, and at 3 and 7 mm apically respect to the crest, both towards the vestibule and palate, generally showed more marked resorption at the crestal level compared to apical measurements. Conclusion: The clinical protocol herein employed for socket preservation showed a positive effect in preventing the physiological post-extraction remodeling. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the hypothesis of a correlation between the preoperative residual alveolar bone height (RBH) and graft maturation after maxillary sinus floor augmentation procedures using two different bone substitutes. Methods: A total of 20 patients who underwent unilateral maxillary sinus floor augmentation with either mineralized deproteinized bovine bone (DBBM) or a xenograft enriched with polymer and gelatin (NBS) were included in this prospective study. Six months after sinus surgery, bone biopsies were harvested with a 3.2 mm diameter trephine bur, prior to dental implant placement. Histomorphometric analysis was performed, and the results were correlated with the individual RBH. Implants were loaded after 5 months of insertion, and 1-year implant success and marginal bone level change were assessed. Results: RBH was 2.17 ± 1.11 mm (range 0.5–3.5 mm) and 2.14 ± 0.72 mm (range 0.5–3.0 mm) in the NBS and DBBM group, respectively. The biopsy analyses for the DBBM group showed woven bone increases by 5.08% per 1-mm increment of RBH; medullary spaces decreased by 9.02%, osteoid decreased by 4.4%, residual biomaterial decreased by 0.34%, and lamellar bone increased by 5.68% per 1-mm increase of RBH. In the NBS group, samples showed woven bone increases by 8.08% per 1-mm increase of RBH; medullary spaces decreased by 0.38%; osteoid increased by 1.34%, residual biomaterial decreased by 0.58%, and lamellar bone decreased by 5.50% per 1-mm increase of RBH. There was no statistically significant difference in the correlation between RBH and lamellar bone, woven bone, and osteoid, independently of the material used. Implant success was 100% in both groups, and marginal bone loss was 1.02 ± 0.42 mm in DBBM and 0.95 ± 0.31 mm in the NBS group after the 1-year follow-up. Conclusion: In spite of the absence of significance, the observed trend for woven bone to increase and medullary spaces to decrease when RBH increases deserves attention. Residual bone dimension might be a determinant in the bone graft maturation after maxillary sinus augmentation. [ABSTRACT FROM AUTHOR]

In the present study, the cytotoxicity and the antimicrobial activity of two silver citrate-based irrigant solutions were investigated. Cytotoxicity of various concentrations (0.25%, 0.5%, 1%, 2.5%, 5%) of both solutions (BioAKT and BioAKT Endo) was assessed on L-929 mouse fibroblasts using the MTT assay. For the quantitative analysis of components, an infrared (I.R.) spectroscopy was performed. The minimum inhibitory and minimal bactericidal concentrations (M.I.C. and M.B.C., respectively) were ascertained on Enterococcus faecalis strain ATCC 4083. For biofilm susceptibility after treatment with the irrigating agent, a minimum biofilm eradication concentration (M.B.E.C.) and confocal laser scanning microscope (C.L.S.M.) assays were performed. Quantification of E. faecalis cell biomass and percentage of live and dead cells in the biomass was appraised. Normality of data was analyzed using the D'Agostino & Pearson's test and the Shapiro–Wilk test. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey's test. Both silver citrate solutions showed mouse fibroblasts viability >70% when diluted to 0.25% and 0.5%. Conversely, at higher concentrations, they were extremely cytotoxic. F.T.-IR spectroscopy measurements of both liquids showed the same spectra, indicating similar chemical characteristics. No substantial contrast in antimicrobial activity was observed among the two silver citrate solutions by using broth microdilution methods, biofilm susceptibility (MBEC-HTP device), and biomass screening using confocal laser scanning microscopy (C.L.S.M.) technique. Both solutions, used as root canal irrigants, exhibited significant antimicrobial activity and low cytocompatibility at dilutions greater than 0.5%. [ABSTRACT FROM AUTHOR]

Aim: This systematic review and meta-analysis aims to assess the additive effect of leukocyte and platelet-rich fibrin (L-PRF) on coronally advanced flap (CAF) procedures in root coverage of Miller's class I and II gingival recession defects. Review methodology: A comprehensive search in MEDLINE (PubMed), Scopus and CENTRAL (the Cochrane Central Register of Controlled Trials), along with an additional hand search, provided eight randomized clinical trials to be included in this review. A total of 167 patients with 470 gingival recession defects were analyzed. A meta-analysis was carried out to assess the change in gingival thickness (GT), width of keratinized gingiva (WKG), root coverage percentage (%RC), clinical attachment level (CAL) and recession depth (RD) at all follow-ups between CAF alone and CAF + L-PRF groups for all included studies. A subgroup analysis was carried out based on recession type (single/multiple). Results: Overall, a significant improvement in GT, CAL and RD was found when treated with CAF + L-PRF. There was a trend for a positive effect in terms of an increase in WKG when using L-PRF, especially in the treatment of single recession, though significance was not achieved (p = 0.08 overall). The results of heterogeneity among the subgroups were varied and were found to be greater than 91.3% for GT and 32.8% for WKG. Conclusion: L-PRF when used in addition to CAF showed favorable results for the treatment of class I and II gingival recession defects. [ABSTRACT FROM AUTHOR]

The present study aimed to perform a systematic critical appraisal of the methodological quality of systematic reviews (SRs) on the effect of autologous platelet concentrates (APCs) in the treatment of periodontal intraosseous defects and to provide a synthesis of the main clinical findings available. An electronic and hand search was performed up to February 2020; 14 systematic reviews of randomized controlled trials (RCTs), of which 11 were meta-analyses, were included. Only one SR fully satisfied all 11 items of the AMSTAR ("A Measurement Tool to Assess Systematic Reviews") checklist for methodological quality evaluation, 3 SRs were classified of high quality, 8 of medium quality, and 2 of low quality. There is some evidence on the beneficial additive effect of APCs in the surgical treatment of intraosseous defects when used alone or in combination with bone grafts. APCs did not show any advantage when used together with guided tissue regeneration (GTR) or enamel matrix derivative (EMD). Undertaking SRs which adhere to rigorous standards and protocols is strongly recommended. There are increasing data on the positive adjunctive effect of APCs in the surgical treatment of intraosseous defects but, due to the heterogeneity of the available primary studies, the quality of evidence remains rather low and further long-term well-designed RCTs are encouraged. [ABSTRACT FROM AUTHOR]

Bioceramic scaffolds are appealing for alveolar bone regeneration, because they are emerging as promising alternatives to autogenous and heterogenous bone grafts. The aim of this systematic review is to answer to the focal question: in critical-sized bone defects in experimental animal models, does the use of a bioceramic scaffolds improve new bone formation, compared with leaving the empty defect without grafting materials or using autogenous bone or deproteinized bovine-derived bone substitutes? Electronic databases were searched using specific search terms. A hand search was also undertaken. Only randomized and controlled studies in the English language, published in peer-reviewed journals between 2013 and 2018, using critical-sized bone defect models in non-medically compromised animals, were considered. Risk of bias assessment was performed using the SYRCLE tool. A meta-analysis was planned to synthesize the evidence, if possible. Thirteen studies reporting on small animal models (six studies on rats and seven on rabbits) were included. The calvarial bone defect was the most common experimental site. The empty defect was used as the only control in all studies except one. In all studies the bioceramic materials demonstrated a trend for better outcomes compared to an empty control. Due to heterogeneity in protocols and outcomes among the included studies, no meta-analysis could be performed. Bioceramics can be considered promising grafting materials, though further evidence is needed. [ABSTRACT FROM AUTHOR]

In oral biology, tissue engineering aims at regenerating functional tissues through a series of key events that occur during alveolar/periodontal tissue formation and growth, by means of scaffolds that deliver signaling molecules and cells. Due to their excellent physicochemical properties and biomimetic features, nanomaterials are attractive alternatives offering many advantages for stimulating cell growth and promoting tissue regeneration through tissue engineering. The main aim of this article was to review the currently available literature to provide an overview of the different nano-scale scaffolds as key factors of tissue engineering for alveolar bone regeneration procedures. In this narrative review, PubMed, Medline, Scopus and Cochrane electronic databases were searched using key words like "tissue engineering", "regenerative medicine", "alveolar bone defects", "alveolar bone regeneration", "nanomaterials", "scaffolds", "nanospheres" and "nanofibrous scaffolds". No limitation regarding language, publication date and study design was set. Hand-searching of the reference list of identified articles was also undertaken. The aim of this article was to give a brief introduction to review the role of different nanoscaffolds for bone regeneration and the main focus was set to underline their role for alveolar bone regeneration procedures. [ABSTRACT FROM AUTHOR]

Hair analysis for the assessment of cannabis active use from passive consumption may be failed when performed by the sole detection of compounds present in plant material as well as in cannabis smoke like Δ-9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol (CBN). For this reason, the determination of 11-nor-9-carboxy-Δ-9-tetrahydrocannabinol (THC-COOH) has been proposed by the Society of Hair Testing (SoHT) in order to prove active cannabis consumption. The identification of THC-COOH in hair will continue to be complicated by its acidic nature and the critical low concentration due to the preferential incorporation of basic compounds into hair shaft. Alternatively, 11-OH-THC may be considered as a complementary marker for THC administration. Our recent study reported an accurate validated procedure for THC, CBD, CBN and 11-OH-THC in hair, based on a GC/MS-MS method in electron ionization mode. However, unlike THC-COOH, a cut-off level for 11-OH-THC in hair has not been fixed yet. For this reason, the aim of this study is to propose a concentration value for 11-OH-THC in hair analysis in order to discriminate between chronic use and external contamination. Receiver operating characteristics (ROC) analysis was applied for cut-off evaluation after 11-OH-THC quantification in a pool of 672 THC-positive hair samples. Results have shown a concentration range between 0.01-5.34 ng/mg for THC (mean 0.34 ng/mg, median 0.12), 0.00-19.2 pg/mg for THC-COOH (mean 0.72 pg/mg, median 0.19 pg/mg) and 0.01-13.33 ng/mg for 11-OH-THC (mean 1.09 ng/mg, median 0.51 ng/mg) for scalp hair and between 0.03-6.32 ng/mg for THC (mean 0.82 ng/mg, median 0.30), 0.00-42.1 pg/mg for THC-COOH (mean 2.70 pg/mg, median 1.08 pg/mg) and 0.00-7.88 ng/mg for 11-OH-THC (mean 1.70 ng/mg, median 0.89 ng/mg) for body hair. Considering these experimental data collected in our laboratory, we propose a cut-off level of 0.5 for scalp and body hair, as indicative of cannabis active consumption. The ROC curve AUCs for 11-OH-THC were 0.873 and 0.884 in 590 scalp hair and 82 body hair samples, respectively. The comparison of the results for THC-COOH (control method) and 11-OH-THC (test method) was also made by means of the Cohen's kappa statistics providing a good agreement according to both Landis & Koch and Fleiss scales. Additionally, we suggest that the detection of both THC-COOH and 11-OH-THC should be mandatory in order to prove active intake and exclude false positive results from external contamination. [ABSTRACT FROM AUTHOR]

Background: The aim of this review was to evaluate the adjunctive effect of autologous platelet concentrates (APCs) for the treatment of furcation defects, in terms of scientific quality of the clinical trials and regeneration parameters assessment. Methods: A systematic search was carried out in the electronic databases MEDLINE, SCOPUS, CENTRAL (Cochrane Central Register of Controlled Trials), and EMBASE, together with hand searching of relevant journals. Two independent reviewers screened the articles yielded in the initial search and retrieved the full-text version of potentially eligible studies. Relevant data and outcomes were extracted from the included studies. Risk of bias assessment was also carried out. The outcome variables, relative to baseline and post-operative defect characteristics (probing pocket depth (PPD), horizontal and vertical clinical attachment loss (HCAL, VCAL), horizontal and vertical furcation depth (HFD, VFD) were considered for meta-analysis. Results: Ten randomized trials were included in this review. Only one study was judged at high risk of bias, while seven had a low risk, testifying to the good level of the evidence of this review. The meta-analysis showed a favorable effect regarding all outcome variables, for APCs used in adjunct to open flap debridement (p < 0.001). Regarding APCs in adjunct to bone grafting, a significant advantage was found only for HCAL (p < 0.001, mean difference 0.74, 95% CI 0.54, 0.94). The sub-group analysis showed that both platelet-rich fibrin and platelet-rich plasma in adjunct with open flap debridement, yielded significantly favorable results. No meta-analysis was performed for APCs in combination with guided tissue regeneration (GTR) as only one study was found. Conclusion: For the treatment of furcation defects APCs may be beneficial as an adjunct to open flap debridement alone and bone grafting, while limited evidence of an effect of APCs when used in combination with GTR was found. [ABSTRACT FROM AUTHOR]